Basic Information
| Provider Information | |||||||||
| NPI: | 1700849031 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RAMIREZ | ||||||||
| FirstName: | JORGE | ||||||||
| MiddleName: | ALBERTO | ||||||||
| NamePrefix: | |||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | RAMIREZ-GONZALEZ | ||||||||
| OtherFirstName: | JORGE | ||||||||
| OtherMiddleName: | ALBERTO | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 7600W TIDWELL RD 103 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770405719 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134613573 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 841 OCEANSIDE DR | ||||||||
| Address2: | |||||||||
| City: | JUNO BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334081749 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2084150595 | ||||||||
| FaxNumber: | 2087633644 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/08/2006 | ||||||||
| LastUpdateDate: | 10/20/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | M9114 | ID | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | ME80213 | FL | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.